title: [Case of shakuyakukanzoto-induced CD4 dominant pneumonitis diagnosed on day eight of the challenge test].
abstract: We report a case of drug-induced pneumonia associated with the herbal medine Syakuyakukanzo-to. A 82-year-old man was admitted to our hospital complaining of cough, fever, and dyspnea after administration of shakuyakukanzoto for two weeks. Drug-induced lymphocyte stimulation tests were negative, but bronchoalveolar lavage showed an increase in lymphocytes with an increased CD4/CD8 ratio. Cessation of the drug improved the patient's clinical and X-ray findings and then he was able to be discharged. He was admitted again for a challenge test. His clinical symptoms and X-ray findings became worse 8 days after re-administration, therefore we diagnosed drug-induced pneumonia caused by Shakuyakukanzoto. He has had no recurrence after discontinuance of the drug. To the best of our knowledge, there has been no previous case of drug-induced pneumonia due to Shakuyakukanzo-to reported in the world.
authors.affiliation: Department of Respiratory Medicine, Seirei Yokohama Hospital.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Fujita
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Nagakawa
authors.forename: Toyoharu
authors.initials: T
authors.lastname: Izawa
authors.forename: Tooru
authors.initials: T
authors.lastname: Okada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.forename: Yuuichi
authors.initials: Y
authors.lastname: Takiguchi
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kuriyama
mesh_terms: D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001985:Bronchial Provocation Tests; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D016516:CD4-CD8 Ratio; D003937:Diagnosis, Differential; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D006035:Glycyrrhiza; D006801:Humans; D008297:Male; D029596:Paeonia; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; C038462:shakuyaku-kanzoh-toh